An International Age- and Gender-Controlled Model for the Spinal Cord Injury Ability Realization Measurement Index (SCI-ARMI)

Abstract

Background. A quadratic formula of the Spinal Cord Injury Ability Realization Measurement Index (SCI-ARMI) has previously been published. This formula was based on a model of Spinal Cord Independence Measure (SCIM95), the 95th percentile of the SCIM III values, which correspond with the American Spinal Injury Association Motor Scores (AMS) of SCI patients. Objective. To further develop the original formula. Setting. Spinal cord injury centers from 6 countries and the Statistical Laboratory, Tel-Aviv University, Israel. Methods. SCIM95 of 661 SCI patients was modeled, using a quantile regression with or without adjustment for age and gender, to calculate SCI-ARMI values. SCI-ARMI gain during rehabilitation and its correlations were examined. Results. A new quadratic SCIM95 model was created. This resembled the previously published model, which yielded similar SCIM95 values in all the countries, after adjustment for age and gender. Without this adjustment, however, only 86% of the non-Israeli SCIM III observations were lower than those SCIM95 values (P < .0001). Adding the variables age and gender to the new model affected the SCIM95 value significantly (P < .04). Adding country information did not add a significant effect (P > .1). SCI-ARMI gain was positive (38.8 ± 22 points, P < .0001) and correlated weakly with admission age and AMS. Conclusions. The original quadratic SCI-ARMI formula is valid for an international population after adjustment for age and gender. The new formula considers more factors that affect functional ability following SCI.

Functional impact of multidisciplinary outpatient program on patients with chronic complete spinal cord injury

“…10 To assess the quality of outcome regardless of the neurological level, the SCI Ability Realization Measurement Index (SCI-ARMI) has been developed as an independent assessment of functional gain after rehabilitation. [10][11][12] Given the very low probability of auto-recovery in patients with American Spinal Injury Association (ASIA) impairment scale A 13 choosing this group of patients minimizes the functional variation between cases due to auto-recovery, and helps attribute any changes to the rehabilitation interventions.…”

Observational study of the effectiveness of spinal cord injury rehabilitation using the Spinal Cord Injury-Ability Realization Measurement Index

“…The initial version of the SCI-ARMI merely took into account the relationship between SCIM and AIS motor scores. 1 A newer version of the instrument that incorporates the effects of age and gender was developed and validated in a multicenter international study, 4 in which the authors chose discharge values, Evaluation of spinal cord injury rehabilitation using SCI-ARMI G Scivoletto et al based on the presumption that at discharge from rehabilitation, ability realization was the highest score that was attainable. Nevertheless, they acknowledged that function might be further enhanced after discharge in certain individuals, necessitating a dedicated study.…”

“…They also affirmed that the formula could be modified to incorporate new clinical variables with regard to their influence in achieving functional potential. 4 Thus, the aims of our retrospective study were to apply the new formula to the data on SCI patients from two SCI centers in Italy to determine whether they were discharged, having achieved their entire rehabilitation potential and study the relationship between SCI-ARMI scores at discharge and clinical variables that, based on previous studies and our clinical experience, could influence functional outcomes in SCI patients.…”

“…A newly published version is based on SCIM III 3 and incorporates clinical (motor scores of the International Standards for Neurological Classification of Spinal Cord Injury) and demographic factors (age and gender). 4 In developing the SCI-ARMI, the 95th percentile of SCIM III values at discharge from rehabilitation (SCIM95) was used to provide a conservative estimate of the maximum possible performance of daily activities for each AMS value. A quadratic formula, based on the data of 661 SCI patients from 6 countries, generated the best estimation of the SCIM95.…”

“…A quadratic formula, based on the data of 661 SCI patients from 6 countries, generated the best estimation of the SCIM95. 4 The original quadratic model for the SCIM95, which was a function of AMS alone, was extended by adding age at admission to rehabilitation and gender as factors. These additions had statistically significant effects on the SCIM95 (P40.03), and there were no interactions with AMS or between age and gender.…”